http://bura.brunel.ac.uk/handle/2438/269 Sat, 13 Jun 2026 09:52:56 GMT 2026-06-13T09:52:56Z http://bura.brunel.ac.uk/handle/2438/33425 Title: Unchartered togetherness: Understanding policy reality as experienced by adults with cerebral palsy Authors: Cook, Gemma Abstract: Adults with Cerebral Palsy (CP) are obligated to navigate complex policy environments to participate in society on an equal basis to others. Although some research has considered the lived experience of navigating complex single-sector policy environments, such as healthcare, the overall multi-sector policy experience has not been explored. This study aimed to fill this gap, through combining arts-based research and lifeworld-research, and to critique the value of what evolved to be a unique research approach. The study comprised two groups of participants: the ‘co-creators’, three adults with CP and CP community leaders; and the ‘audience’, fifteen adults with CP and / or policy stakeholders. Data collection started with co-creator creative-workshops that resulted in a spoken-word performance, a wall-mural and a poetry-film. Audience involvement followed with an artwork screening, a question-and-answer session with the co-creators, and mini-interviews. Thematic analysis was used to analyse the datasets. The findings inferred that policy had a direct and dramatic impact on the personhood of adults with CP. The co-creator’s policy experiences meant wayfaring through multiple barriers and confusing contradictions in the face of tenacious stigma which required relentless renegotiation of identity. Understanding policy experience proved temporal and involved returning to childhood memories to make sense of adulthood. A strange belonging was felt alongside pride and positivity and sense of purpose to effect progressive change. The audience deepened meaning by identifying and further unpacking concepts around the discordant nature of policy environments, revealed to be multicentric, lacking in leadership, with a suggestion that unintended policy outcomes may be going unseen. Combining arts-based and lifeworld research enabled heuristic learning and knowledge transfer. Framing these with critical realism and human rights definitions, facilitated a systematised investigation into an ambiguous topic, resulting in a contextual kaleidoscope of multiple perspectives and layered meaning that proved suited to researching social worlds. Description: This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University Wed, 01 Jan 2025 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/33425 2025-01-01T00:00:00Z http://bura.brunel.ac.uk/handle/2438/33408 Title: Development and feasibility evaluation of a sedentary behaviour intervention in individuals with paraplegia Authors: Cooper, Daniel Lee Abstract: Background: Individuals with spinal cord injury (SCI), such as paraplegia, are at a higher risk of cardiovascular disease (CVD) than non-disabled individuals. Furthermore, these individuals have high levels of sedentary behaviour, which is an independent risk factor for CVD. Reducing and breaking up sedentary behaviour could be a potential intervention focus for individuals with paraplegia. Currently, evidence around the effectiveness of sedentary behaviour interventions in individuals with paraplegia is unclear. Sedentary behaviour interventions have been shown to be effective in non-disabled individuals. However, due to the unique needs of manual wheelchair-users with paraplegia, it is unlikely that interventions designed for non-disabled individuals would be acceptable or effective for this population. Therefore, tailored sedentary behaviour interventions should be developed for individuals with paraplegia. Methods: A mixed-methods approach was used throughout this thesis. The initial ‘Development’ phase of the Medical Research Council (MRC) framework for developing and evaluating complex interventions was undertaken via a systematic review to explore the effects of interventions on sedentary behaviour and CVD biomarkers in individuals with paraplegia (Chapter 4), and development of a sedentary behaviour intervention using the Behaviour Change Wheel (Chapter 5). Subsequently, the ‘Feasibility’ phase of the MRC framework was undertaken via a feasibility study to evaluate the acceptability, safety, feasibility and preliminary efficacy of the intervention in individuals with paraplegia (Chapter 6). Results: The systematic review found that interventions specifically targeting sedentary behaviour show promise for improving this outcome and CVD biomarkers. The co-design study identified 29 barriers and facilitators to reducing and breaking up sedentary behaviour, which were then selectively targeted by specific intervention components: a wearable activity tracker, educational booklet, goal setting, motivational support, peer support and activity tools. Evaluation of this intervention found that it was acceptable, safe and feasible. In addition, the intervention showed preliminary efficacy for improving sedentary behaviour, physical activity, some CVD biomarkers and psychosocial health outcomes. Conclusion: This research contributes a novel co-designed, theory-driven sedentary behaviour intervention in individuals with paraplegia. The intervention was acceptable, safe and feasible to deliver, which can inform progression to a future definitive randomised controlled trial. If found to be effective, this research could inform future healthcare policy and public health guidelines in individuals with paraplegia, with a focus on reducing and breaking up sedentary behaviour to improve CVD biomarkers. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London Thu, 01 Jan 2026 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/33408 2026-01-01T00:00:00Z http://bura.brunel.ac.uk/handle/2438/32852 Title: Exploring the impact of training in psychological support for long-term injured athletes on sport psychologists’ professional development and practice Authors: Pickford, Helen Abstract: This research explores the professional development of sport and exercise psychologists in supporting long-term injured athletes. The objectives of this research were to design and deliver a theoretically grounded professional skills workshop (‘Injury informed Acceptance and Commitment Therapy’- IACT) for sport psychology practitioners and explore the practitioners’ perceptions of the impact of training on their practice. Injury is well-recognised to have significant psychological consequences for athletes, and while practitioners regularly work to support them, there is currently a paucity of training available on this important topic. The study used an applied interpretive methodology with principles of integrated knowledge translation and a practice-based approach to explore professional development. Sport psychology practitioners attended a one-day CPD workshop that aimed to equip practitioners with the necessary skills and knowledge to better support long-term injured athletes. The CPD was designed and developed to meet the needs of practitioners including understanding the injury journey and the associated mental health risks for athletes, ACT therapeutic skills, and evidence-based practice. Data were collected through questionnaires, focus-group interviews, and follow-up interviews with practitioners at 3- and 6-months post workshop. Results showed that the IACT workshop was effective CPD training, improving practitioners’ knowledge and understanding of the injury journey, the potential impacts on athlete mental health, and their confidence in being able to effectively support injured athletes. Results from follow-up interviews showed that practitioners perceived the workshop to have significant, wide-ranging impacts on their practice, and findings were organised into five general dimensions; ‘Self’, ‘Therapeutic Alliance’, ‘Working Alliance’, ‘Process and Organisation’, and ‘Beyond’, conceptualised as a ‘ripple effect’. This research adds important practice-based evidence and concludes that current training requirements for sport psychologists in this area are insufficient, and more training of this kind needs to be available to protect athlete wellbeing, bridge the research-practice gap, and develop the profession. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London Wed, 01 Jan 2025 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/32852 2025-01-01T00:00:00Z http://bura.brunel.ac.uk/handle/2438/32412 Title: The Effect of Ergometer Cycling and Visual Foraging on Brain Function: A Pilot Study Authors: Dkaidek, T; Dingley, A; Parsler, J; Broadbent, D; Szameitat, A; Bishop, D Abstract: Dual-task training comprising cognitive and physical components may enhance cognitive function, and increased prefrontal cortex activation may underpin these improvements. The aim of this pilot study was to examine the effects of cycling and visual foraging on executive function (EF). Twenty-seven participants (mean age 25.44 ± 4.31 years) completed four lab-based sessions, one in which their aerobic capacity (O2max) and baseline EF scores assessed were determined, and three randomized experimental conditions: ergometer cycling (EC), visual foraging (VF) and both combined (EC + VF). Participants’ EF performance was assessed at baseline, and pre-and post- intervention using the 2-Back task (working memory), the Flanker Task (inhibitory control), and the Wisconsin Card Sorting Task (WCST; task switching). Functional near-infrared spectroscopy (fNIRS) and eye-tracking data were collected throughout each condition. Affective state was assessed via the Affect Grid. Repeated measures ANCOVAs, incorporating baseline EF task scores as covariates, revealed condition x time x covariate interactions for the Flanker task only; task performance of participants with poorer baseline scores improved more profoundly in the EC condition. Subjective arousal and prefrontal cortex (PFC) activation were higher in both cycling conditions relative to VF; hence, ergometer cycling, rather than visual foraging, might be the more impactful intervention in these regards. However, these elevations were not associated with EF enhancements; near-ceiling effects in EF task performance may explain this. The EC condition elicited greater energetic investment than the EC + VF condition; possibly because the secondary VF task distracted from the cycling exercise. PFC activation was only correlated with gaze fixations during the EC + VF condition, potentially reflecting concurrent increases in supply of, and demand for, oxygen during the combined condition. Description: Data Availability: All relevant data are within the manuscript and its Supporting Information files.; Supporting information is available online at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0336642#sec021 . Mon, 01 Dec 2025 00:00:00 GMT http://bura.brunel.ac.uk/handle/2438/32412 2025-12-01T00:00:00Z